The broad aim of the proposed UCSF Multidisciplinary Clinical Research Center Program (UCSF MCRC) is to improve outcomes for persons with various forms of rheumatic diseases by discovery of the medical, demographic, and contextual factors affecting those outcomes. This overarching aim is pursued by a comprehensive program of clinical research in the rheumatic diseases, including but not limited to that within the MCRC; by serving as a catalyst for such clinical research throughout UCSF; and by systematic training of clinical investigators in the rheumatic diseases. The MCRC consists of an Administrative Unit, Methodology Core, four five-year projects, and a three-year Development and Feasibility (D&F) Study. The participants in the MCRC span three UCSF schools (Medicine, Nursing, and Dentistry) and UC, Davis and include representatives of nine discrete academic units, including the UCSF GCRC. The Center's Director and Associate Director are Drs. Edward Yelin and Lindsey Criswell, respectively. The Director of the Core Unit is Dr. Patricia Katz. The activities of the MCRC are guided on a day-to-day basis by an Executive Committee. Strategic oversight of the Center is provided by Internal (UCSF) and External Advisory Committees. The Center will also have a mentorship committee of our most senior former trainees, now all in academic medicine at UCSF and three other medical schools, the Graduates' Council. The research of the MCRC is based on analysis of longitudinal primary data about two specific diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). The primary data, the Lupus Outcomes Study, and the Rheumatoid Arthritis Outcomes Study, are shared across MCRC projects. Design and implementation of these two datasets occurs in the Methodology Core Unit. The Core Unit is also repsonsible for biostatistical consulting and mentorship of faculty and fellows in emerging methods of analysis. The specific five-year projects are: Project 1: Genetics, Ancestry, and SLE Outcomes (Lindsey Criswell, P.I); Project 2: The Impact of Obesity and Physical Activity on Depression in RA and SLE (Patricia Katz, P.I.); and Project 3: Health Care Factors Affecting Outcomes of Vulnerable Populations with SLE (Edward Yelin, P.I.). The D&F Study is: The Development of a Tailored Symptom Assessment Tool to Enhance Patient-Centered Care in RA (Jennifer Barton, P.I.).